4/3/2010

4/3/2010
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What is Assessment?
Process of Assessment
Theories that help
Sample Assessment statements from case studies
Discuss in groups of two or three
y Social Work is a dynamic and multi‐faceted profession that works towards enhancing human well‐being and social conditions. It is a profession governed by the ethical values and principles and based on theoretical body of knowledge and systematic approach of assessment, intervention and action plans. ‐ Singapore Association of Social Workers
y Social Work is the professional activity of helping individuals, groups, or communities enhance or restore their capacity for social functioning and creating societal conditions favourable to this goal. y Social Work practice consists of the professional application of Social Work values, principles, and techniques to one or more of the following ends: helping people obtain tangible services; counselling and psychotherapy with individuals, families, and groups; helping communities or groups provide or improve processes. y The practice of Social Work requires knowledge of human development and behaviour; of social, economic, and cultural institutions; and of the interactions of all these factors. (National Association of Social Workers ‐
USA)
y A paid professional activity which involves working with both adults and children to help them try and resolve practical and interpersonal difficulties in order to enable them to function and participate more effectively. • This can be on an individual basis or within families, or working with groups or communities to improve their inter‐social or personal competencies through the provision of a range of services and interventions. • This may also involve the use of statutory controlling powers as well as more therapeutic support. – Juliette Oko, Author
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y Social Work is the act of helping individuals/families who are marginalised or individuals/families who are for various reasons finding it difficult to fit with or lagging behind the mainstream society.
This definition gives us a certain direction for our assessment as we attempt to work with our clients
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‚ i.e. we are trying to assess why our clients/families are not managing.
y A professional view of the client’s/family’s situation which is based on literature/theory (explanatory models)/ theoretical framework (organizational models) that should automatically inform practice.
y Principles of assessment
‚ Tentative
‚ Based on theory/literature/ frameworks
‚ Relate to client’s presenting problem or request
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•Identification of needs and concerns
• Making theoretically based assumptions about
the nature of the need or concern.
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• Exploring strengths and resources in the family
system.
Each family might present a whole list of issues
Given your own theoretical orientation, you might pick up a whole list of things that you might want to explore
How do you decide what is your focus and what you should be looking at?
• Critical of
Mdm S
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27
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• Out of
school
Mdm S
Missing
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R
• Failing in school
• Speaks little English
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J
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• Irregular job patterns
• Overweight
•Chronic health conditions
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Level 1: Whether families are able to provide for the basic needs of the members
Level 2: Whether families are able to provide basic structure for members to feel nurtured and safe space for growth
Level 3: Whether families are able to provide connectedness for support, according to their own life stage
Level 4: Whether families are able to provide greater sense of individual self actualisation and address issues with intimacy and deeper yearnings
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Furnishing & Decorations
Level 4
•Whether parents have any “unfinished
business” with their own parents and
how that might have impact on the
degree of intimacy they are comfortable
with as individuals and as parents
(Richness & Quality)
III
Placement of Walls & Doors
(Space & Boundaries)
II
Framing and Roof
(Structure and Organization)
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Basement/Foundation
(Basic Survival)
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Level 3
• Whether parents are suitably engaged
or disengaged from their children and
how that might have an impact on how
they are doing in school
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Level 2
•Whether parents are taking drugs in
front of their children
As Social Workers, the level that is of primary interest would be level 1 and 2
For most our families, they might come with issues that are present at all levels.
Important to acknowledge the interconnectedness of the different issues
Level 1
•Whether parents are able to provide
for their children to ensure they have
basic nutrition
Very often, we move from observation to intervention or from our theoretical orientation (or practised techniques) into intervention
The difficulty in doing this might be we might assume wrongly or we might get too caught up with what we want to do rather than what the client wants
Inductive and deductive method
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y Observation, Evaluation, Intervention (Inductive)
‚ In sessions, you noticed that whenever mother speaks, everyone in the family would keep quiet, including father. You notice how father might shift uncomfortably in his seat sometimes but yet does not seem to verbalise his discomfort. (Observation)
‚ One possible hypothesis might be how the structure in the family is such that father is being relegated to the sibling sub‐system, while mother is only one who holds the executive sub‐system position.
‚ Father in his sibling sub‐system position might then be “invited” to “rebel” passive aggressively against mother/wife and hence making it difficult for the family to manage their difficulties
‚ Intervention might be to look at how you could work with the executive sub‐system
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We could start with any observation
Of all the observations that we could pick up, how do we explain to ourselves why this particular observation stood out for us? What does that say about us?
As we pick up this observation, might there be any other p
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observation that we could have missed out?
How do we make sense of this observation that we are observing? Am i able to identify the theoretical ideas or concepts that i am influenced by?
How am i being “invited” to intervene as i think about this case in this manner?
Is there another way in which i could see?
Formulation, Evidence, Intervention (Deductive)
We could start with a formulation/hypothesis and use that formulation/hypothesis to work with our clients/families.
Evaluate the “validity” of the hypothesis through questioning or through observation of behaviours
Important to also evaluate how it “fits” the client
Important to consider how by seeing the case in this way, what ideas you might be privileging and what others might you be putting aside
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A client 26, divorced twice with 2 children 8 and 5
Connecting to ideas related to individual life cycle, grief and loss of divorced families, dominant discourses about how women should be, i might be curious about how client make sense of her own current situation. Does she feel support from her family? How would support look like for her? Using this as a perspective lens, I go into session exploring these ideas: Social Support, issues of shame, how her family see her etc.
These will have an impact on how I see the case and how it might have an impact on how I position myself with her so that I do not become the “second family” that shame her or “look down” on her
y Explanatory models – Explains why certain phenomenon takes place
y Our perspective lens
y We cannot not have theories
y Theory in use and Espoused theories
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It is actually really a dynamic process (not lineal)
Observation‐evaluation‐intervention‐observation‐
evaluation‐intervention
Formulation/hypothesis – evidence Formulation/hypothesis evidence – intervention – formulation/hypothesis – evidence – intervention
Responding to feedback
Constantly asking: How am I looking at this case and how by the way I see this case have an impact on how I work in the case? How does this fit?
• A context that can frame individual identity and development and to account for the effects of the social system.
• The family seen as a system moving through time.
• Each life cycle stage explained through emotional process of Each life cycle stage explained through emotional process of
transition and second‐order changes required for family to proceed developmentally.
• More than one generation may need to adjust to life cycle changes simultaneously – events at one level have a powerful effect on relationships at each other level. • Important to note cultural differences in definition of life stages.
Family Life Cycle Stage
Emotional Process of Transitions
2nd order changes required to proceed developmentally
Family Life Cycle Stage
Emotional Process of Transitions
2nd order changes required to proceed developmentally
Single Young Adults
Accepting emotional & financial responsibility for self
• Differentiation of self
• Devt of intimate relationships
• Establish self in work and financial independence
Families with adolescents Increasing flexibility of family boundaries to permit children’s independence and grandparents’ frailties
The New Couple
Commitment to new system
• Formation of marital system
• Realignment of relationships
with extended families & friends to include spouse.
• Shifting of parent‐child relationships to permit adolescent to move in and out of system
• Refocus on midlife marital and career issues
• Beginning shift toward caring of older generation
Launching children and moving on
Accepting a multitude of exits from and entries into the family system.
• Renegotiation of marital system as dyad
• Devt of adult‐adult relationships
between grown children and their parents.
• Realignment of relationships to include in‐laws and grandchildren
• Dealing with disabilities and death of parents (grandparents)
Families with Young Children
Accepting new member into the system
• Adjusting marital system to make space for children • Joining in child rearing, financial and & household tasks.
• Realignment of relationships with extended family. 4
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Family Life Cycle Stage
Emotional Process of Transitions
2nd order changes required to proceed developmentally
Families in later life
Accepting the shifting generational roles
• Maintaining own and/or couple functioning and interests in face of physiological decline
• Support for more central role of middle generation g
• Making room in the system for the wisdom and experience of the elderly, supporting the older generation without overfunctioning for them
• Dealing with loss of spouse, siblings, and other peers and preparation for death.
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As families move along, stress is often greatest at transition points.
Takes a lot of rebalancing, redefining and realigning of relationships.
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Although all normative change is to some degree stressful, when horizontal stress intersects with vertical stress, there tends to be an impact in the system. The whole is greater than sum of its parts
Vertical Stressors • Family history
• Values, beliefs, expectations, labels we grow up with • Patterns of relating and functioning that are transmitted down generations
down generations
Horizontal Stressors •Describes the family as it moves through time, coping with the changes & transitions. •Developmental & normative events e.g. life cycle transitions
• Unpredictable or non‐
normative events e.g. job loss, chronic illness, birth of disabled child.
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Equifinality
‚ Looking at patterns of behaviour within the family
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Circular Causality instead of linear causality
‚ See behaviours as within context and how they are inter‐related as opposed to being “caused” by some factors
Genogram
Family Time Line
Ecomap
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Homeostasis
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‚ Looking at different relationships and how each relationship have an impact on the other
Time
‚ See families as self correcting, stable organisms. Any change would be countered by another change which would bring the system back to stability
Systems as open systems or closed systems
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Closed to information. Self re‐generating (autopoietic systems)
Structural determinism
See change as happening because it fits the structure
You cannot “make” a wall dance
Open systems responds to feedback and could be directed to change
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1st order change and 2nd order change
‚ Change that does not change anything versus a more profound change
‚ A difference that makes a difference
‚ A husband and wife might quarrel more or quarrel less. Go out A husband and wife might quarrel more or quarrel less Go out more or go out less. All these could be seen as 1st order change within a larger context of how husband is always the “leader” in the relationship
‚ Second order change might be a more profound change in the dynamics of the relationship ‚ Analogy of the gear box in the car
2. Mdm S also appears rather punitive in the way she manages the behaviour of her children, especially R. She has shared how R reminds her of her ex‐
husband. This might have an impact on how she might have certain transference issues that might be projected onto R. (Transference issues, risk assessment, level 2)
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4.Both R and J are often observed to be left on their own to play in the neighbourhood with little or no supervision when mother is working. Mother also has little or no energy left to manage them after she comes back from work. This might contribute to the children underachieving in school. (Disengagement, boundaries, level 2, level 3) 1. Mdm S appears to have difficulty in managing the family subsistence with her own irregular job patterns, which might be contributed by her g
difficulties in balancing between care giving for her children and bringing home the income for her family. (Single parenthood issues, single parenthood life cycle, level 1)
3. As Mdm S copes with managing her single parenthood, she might have been further challenged by various intra‐personal issues such as chronic asthma and weight issues. This challenge might be further exacerbated by her mother’s involvement in many of her decision making process. Her mother is also observed to be critical of her in many ways. (Individual life cycle, normative stressors, appropriate boundaries, level 3)
5. Divorce might have been traumatic for Mdm S and coupled with beliefs and ideas about how she might be “rejected” as a woman, she might feel a certain sense of shame and how that also appears to be similar to the larger discourse “i am not good enough” that oppresses her. (Narrative ideas, non‐
normative stressors, vertical stressors, level 4) 6
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Get into groups of 6 & discuss how you might assess the families
the families’ situations.
situations.
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What theory informs the assessment?
How is that related to the presenting problem or the request of the client?
How does this assessment invite you to intervene or act with the client?
How does this assessment “fit” the client?
‚ If you were to share this assessment with your client, what might they say about your assessment?
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Is Assessment something that you do to, or with clients/families. What is the difference?
How does my self (social GRRAACCEESS, John Burnham) and my theoretical “allegiance” have an )
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impact on my views on the case
‚ Are there any other possibilities?
‚ Are we limiting possible conversations?
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Assessment and therapeutic relationship
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Formulation in psychology and psychotherapy: Lucy Johnstone and Rudi Dallos
Family therapy: a systemic integration: Becvar and Becvar
Working with families: an integrative model by level of need: Kilpatrick and holland
Expanded family life cycle: Carter and Mcgoldrick
‚ When and how should i share my assessment? Intent if i do? Issues of power?
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